<!doctype html>
<html>

	<head>
		<meta charset="UTF-8">
		<title></title>
		<meta name="viewport" content="width=device-width,initial-scale=1,minimum-scale=1,maximum-scale=1,user-scalable=no" />
		<link rel="stylesheet" href="//cdn.bootcss.com/bootstrap/3.3.5/css/bootstrap.min.css">
		<link href="css/mui.min.css" rel="stylesheet" />
		<script src="//cdn.bootcss.com/jquery/1.11.3/jquery.min.js"></script>
		<script type="text/javascript" src="js/jquery.params.js" ></script>
		<script type="text/javascript" src="js/report.js" ></script>
		<script type="text/javascript" src="//res.wx.qq.com/open/js/jweixin-1.0.0.js"></script>
		<script src="//cdn.bootcss.com/bootstrap/3.3.5/js/bootstrap.min.js"></script>
		<style type="text/css">
			body{
				background: #f3f3f3;
				font-family: 黑体;
				color: #111;
			}
			.c_form{
				width:100%;
				background: #fff;
				padding:10px;
				margin-top: 10px;
				border-radius:10px;
				font-size: 17px;
			}
			input{
				border:none;
				width:60%;
			}
			.c_input{
				margin: 10px;
				font-size: 17px;
			}
			.c_select{
				width: 80%;
				border: none;
				height: 33px;
			}
			.c_select_1{
				width: 50%;
				float: left;
			}
		</style>
	</head>

	<body>
		<div class="container">
			<form>
				<div class="c_form">
					<div class="c_input c_hid" >
					姓&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;名:<input type="text" id="name"  />
					</div>
					<div class="c_input c_hid" >
					身份证号:<input type="text" id="cid" />
					</div>
					<div class="c_input d_gid c_hid" style="display: none" >
						护照编号:<input type="text" id="gid" value="null"/>
					</div>
					<div class="c_input d_cardid c_hid" style="display: none">
					银行卡号:<input type="text" id="cardid"   />
					</div>
					<div class="c_input d_phone c_hid" style="display: none">
					电&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;话:<input type="text" id="phone" />
					</div>
					<div class="c_input d_phone c_hid">
						邮&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;箱:<input type="text" id="email" placeholder="请填写接收信用报告的邮箱" />
					</div>

				</div>
				
				<div class="c_input">
					
					<div style="padding-top: 30px;">
						 <button style="height: 45px;" onclick="reportSubmit()"  class="btn btn-info btn-block" type="button">提交</button>
					</div>
					<BR>
					<p style="color:red;">PS:信用报告是以附件的形式发送到邮箱,请务必填写邮箱</p>
					
				</div>

			</form>
				
			</div>


		<!-- Modal -->
		<div class="modal fade" id="myModal" tabindex="-1" role="dialog" aria-labelledby="myModalLabel" aria-hidden="true">
			<div class="modal-dialog">
				<div class="modal-content">
					<div class="modal-header">
						<button type="button" class="close" data-dismiss="modal"><span aria-hidden="true">&times;</span><span class="sr-only">Close</span></button>
						<h4 class="modal-title" id="myModalLabel">提示:</h4>
					</div>
					<div class="modal-body">
						邮件发送成功!
					</div>
					<div class="modal-footer">
						<button type="button" class="btn btn-info" data-dismiss="modal" >X 关闭</button>
					</div>
				</div>
			</div>
		</div>






		</div>
	</body>

</html>